cognitive processing therapy
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2021 ◽  
Author(s):  
John R. Keefe ◽  
Samantha Hernandez ◽  
Camila Johanek ◽  
Meredith S.H. Landy ◽  
Iris Sijercic ◽  
...  

2021 ◽  
pp. 088626052110550
Author(s):  
Nicole M. Christ ◽  
Rachel C. Blain ◽  
Nicole D. Pukay-Martin ◽  
Jessica M. Petri ◽  
Kathleen M. Chard

The Veterans Health Administration (VHA) has called for improved assessment and intervention for survivors of military sexual trauma (MST) to mitigate deleterious sequalae, including posttraumatic stress disorder (PTSD). Research on the impact of MST-related PTSD (MST-IT) on men is limited, and few studies have examined the differential effects of treatment across genders and MST-IT. Additionally, studies have utilized varying definitions of MST (e.g., sexual assault only vs. including sexual harassment), contributing to disparate outcomes across studies. Utilizing data from 343 veterans seeking residential cognitive processing therapy (CPT) for PTSD in VHA, this study examined the impact of MST-IT and gender on differences in demographic characteristics; pre-treatment severity of PTSD (overall and clusters), depression, and negative posttraumatic cognitions (NPCs); and post-treatment severity of these variables after accounting for pre-treatment severity. Results from 2x2 factorial ANOVAs found no differences in pre-treatment depression or overall PTSD by MST-IT, gender, or their interaction; however, MST-IT survivors presented with greater pre-treatment avoidance, global NPCs, and self-blame. Results from hierarchical linear regression models found only pre-treatment symptom severity significantly predicted post-treatment severity for overall PTSD and all NPCs. These findings suggest veteran survivors of MST-IT appear to benefit similarly from CPT delivered in a VHA residential PTSD program compared to veterans with other index traumas, regardless of gender. Although there were minimal post-treatment differences in PTSD and NPCs by MST-IT status and gender, residual symptoms related to negative cognitions and mood appear to differ across gender and MST-IT status. Specifically, in individuals without MST-IT, post-treatment PTSD symptoms of negative alterations in cognition and mood were higher in men than women. Moreover, women with MST-IT reported more symptoms of depression than both men with MST-IT and women without MST-IT. These findings suggest depressive symptoms decrease through residential PTSD treatment differentially by MST-IT status and gender and warrant further examination.


2021 ◽  
pp. 088626052110435
Author(s):  
Sophie E. Haven ◽  
Wilson J. Brown ◽  
Jillian B. Berfield ◽  
Steven E. Bruce

With the establishment of empirically validated treatments for posttraumatic stress disorder (PTSD), concerns remain regarding the effectiveness of such treatments in real-world clinical settings. Specifically, premature termination and treatment response limit the effectiveness of these interventions. The current study investigated factors potentially related to premature termination and treatment response in Cognitive Processing Therapy with Account (CPT-A). Participants in this study included 42 women ( Mage = 30.70 SDage = 9.40) with PTSD from exposure to interpersonal trauma. Demographic characteristics, pre-treatment symptoms of PTSD and depression, and transdiagnostic factors were examined as predictors of attrition and treatment response. Hierarchical regression and logistic regression models were analyzed to test the variance explained and predictive value of these factors. The present study revealed that age was a significant factor related to dropout from CPT-A whereas baseline PTSD symptom severity was significantly related to treatment response. Results of this study suggest the importance of the interrelationships among pre-treatment predictors as well as the consideration of attrition and treatment response as distinct metrics of treatment outcome. Further, these results inform the application of CPT-A for PTSD in survivors of interpersonal trauma, as consideration of the identified predictors of dropout and non-response at intake may contribute to treatment retention and response.


2021 ◽  
Author(s):  
Muhammad Rais Baig ◽  
Jennifer L. Wilson ◽  
Robert D. Beck ◽  
Jennifer A. Lemmer ◽  
Adeel Meraj ◽  
...  

Abstract BackgroundThe limited efficacy of first-line treatment of posttraumatic stress disorder (PTSD) with selective serotonergic reuptake inhibitors commonly leads to the use of multiple medications that still fail to achieve symptomatic remission. VA/DOD guidelines identify trauma-focused psychotherapies as the evidence-based treatment for PTSD, but overall effectiveness is limited by reduced levels of patient engagement. Cognitive processing therapy (CPT) is the most widely-used trauma-focused therapy in the VA system for Veterans with PTSD. Our previous results based on a case series suggested that quetiapine monotherapy, but not risperidone or valproate, could increase engagement in CPT, thereby improving clinical outcomes through direct medication effects and indirectly through greater engagement in CPT.Methods & ResultsWe report the study protocol of a pilot study. This randomized, double blind placebo-controlled study was designed to evaluate the feasibility, safety, and preliminary efficacy of completing a randomized trial of quetiapine vs. placebo as an adjunct to promote patient engagement in CPT treatment for PTSD.ConclusionsWe expect that the success of this ongoing study should provide us with the preliminary data necessary to design a full-scale randomized trial.Trial Registration:NCT04280965


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